A Map to Public Safety--Or to Nowhere: Big Pharma’s Influence on Mental Health Policy Post-Sandy Hook
by Rolf Maurer
"Diagnosis [as spelled out in the DSM-IV] is part of the magic...you know those medieval maps? In the places where they didn't know what was going on, they wrote 'Dragons live here'...we have a dragon's world here. But you wouldn't want to be without the map."
-- Dr. Allen Frances, Editorial Director, Diagnostic and Statistical Manual of Mental Disorders-IV (American Psychiatric Association, 1994)
Following the Newtown Massacre last December, national attention has focused with exhaustive detail on gun types and proliferation, while, at the same time settling for irresponsible vagueries when it comes to defining improved mental health policy. Given the disastrous role public/private sector-led psychiatric intervention programs have had on the young, this calls into question which is the real problem: too easy access to dangerous weapons by unbalanced individuals, or too much access to physiologically susceptible populations (and possibly the public at large) by pharmaceutical interests powerful enough to shape the terms of mental health and its effective treatment?
When you have the long-overdue disclosure of toxicology findings on Newtown shooter Adam Lanza's body first appearing in late May (with the complete report released last month following a suit lodged by AbleChild.org) preceded by months of dismissive stonewalling from both state medical examiner, Dr. H. Wayne Carver and even Governor Malloy in response to petitioning Newtown parents, you have to wonder where Hartford’s priorities lie. (1)
Even if the near-insultingly unconvincing media claims that emerged mid-May of no evidence of medication, alcohol, or illegal drugs in Lanza’s system are credible, officials fail to acknowledge that numerous past shooters were known to act out violently in response to abruptly going off their medications (as was the case in two instances in 2008 and one in 2009) (2), as well as reacting adversely to faithful use of them.
Given the prominent role prescription psychotropic drugs have played in this and nearly fourteen other domestic mass shootings involving teens or young adults over the last few years (still more if you include international figures) (3), it is hard to understand how resorting to prescribing more of these sort of drugs to children in the name of "expanding mental health services" is going to do anything but result in more acts of mass violence.
Inasmuch as how particularly devastating guns can be, curtailing their availability to any degree, however comprehensive, will no more curb violence if someone is determined to kill many people under the influence of Paxil or Zoloft than would the motive of a twenty-year-old in rural Connecticut to commit matricide be identical with the motive to kill schoolchildren he didn’t even know. After all, the same day of the shooting, a disturbed man went on a rampage in a school in China wielding a knife. (4)
A more ironic coincidence from last December was the shutdown of TeenScreen, a nationwide in-school psychiatric counseling program cancelled because the lives of normal, healthy students around the country were either ended or ruined as a result of a psychiatrist labeling them with some disorder, resulting in prescriptions that made them violent or suicidal. This program was expanded from a single-state program under the auspices of the 2002 Federal New Freedom Commission, which was nothing more than a way for Eli Lilly to gain access to the country's students in an effort to eventually get everyone mentally screened (and, presumably, medicated) from “birth to old age” (5).
Devolved in the last administration from George Bush Junior’s catastrophic Texas Medical Algorithm Project (TMAP), when he was governor, TeenScreen, developed by psychiatrist and pharmaceutical consultant David Schaffer, involved targeting students for psychotropic medications under the guise of preventative intervention for at-risk teenagers. Bribing them with free pizza, or even passes to the local multiplex, students would submit to a multiple-choice test evaluating their purported predisposition to depression or suicidal ideation. These tests would include such ridiculously general or leading questions as whether the student felt uncomfortable speaking before large crowds (who doesn’t?), or if they preferred being alone/or in groups (again, who doesn’t at different times?). If you’re a fan of the actor Jude Law you can glimpse his psychiatrist character going over the results of one such test in Side Effects, a thriller that, for all its egregious punch-pulling, does a fair job in exploring the collusion of medicine and Big Pharma.
Interestingly, as a UK national practicing stateside, Law’s character in the film is called into question by American authorities when one of his patients is accused of murder under the influence of a fictional medication he prescribed—ironic given how much more severe criticism there is in the UK against psychotropics than here.
The nationwide version of TeenScreen was often implemented on an “opt-out”, or “passive consent” basis, meaning parents had to submit express objections to their child participating, as no response would be construed as granting permission. Former investigator for the Pennsylvania Office of the Inspector General Allen Jones has attested to the consequences for both students and parents who trust in the judgment of authority figures leading to devastating results, wherein an intelligent, outgoing teen came home from school with a diagnosis of two disorders and was dead by suicide within months following her parents dutifully taking her to a doctor and putting her on prescriptions. (6)
Among Connecticut students, of the 760 offered screening between 2005 and 2010 at the state’s two participating schools/TeenScreen sites, 171 accepted evaluation. (7)
The NRA of Drugs
While less than 25 percent, it was frustration with a still lower turnout in Pinellas County, Florida on the part of Dr. Laurie Flynn of Columbia University (co-director of the program) that inadvertently helped contribute to its closure. Clearwater resident Sylvia DeWall became suspicious of TeenScreen’s real purpose after a TV news report aired in her area, leading to the resignation of Flynn and co-director Leslie McGuire (who has since joined AmeriCares in Stamford, CT). (8)
Parent outrage only intensified when an email between Flynn and a TeenScreen school district liaison revealed the exploitive callousness of the operation, wherein the former head of the National Association of the Mentally Ill (which, in receipt of 75 percent of funding from drug companies as of 2009, is a veritable NRA of the psychotropic drug field) (9) complained about the low turnout for TeenScreen in Pinellas: “I’m looking for a horse to ride here!... I need to get some kids screened—if the schools are a road block (sic) we are interested in community organizations.” (10)
From How to Influence People to Telling Them What is Normal
But why the dominant push for psychiatric drugs to begin with? As it turns out, this trend goes back to the early 1970s, when, according to Dr. Peter Breggin’s Toxic Psychiatry (St. Martin's Press, 1991), drug makers agreed to assist a flagging talk therapy-based psychiatric field, besieged by a variety of competing new approaches, by seeding peer publications and medical venues with studies promoting the efficacy of an exclusively biological basis for mental disorders. (11)
Historically, according to Barbara Ehrenreich in Bright-Sided (Picador, 2010), the morphing of the 1800s “New Thought” movement into today’s “Positive Psychology” beginning with the writings of Dale Carnegie, Norman Vincent Peale, Napoleon Hill and many contemporary imitators, supported symptom--rather than cause-based--psychology, which snuggly suited the interests of the insurance industry.
Meanwhile, with each successive version of the Diagnostic and Statistical Manual of Mental Disorders (the definitive reference of the mental health field), published through the American Psychiatric Association, more and more emotional states are now considered forms of mental illness. The fifth and latest version of the DSM (an edition whose contents have been the subject of much controversy even years before publication) now characterizes just about EVERYONE as a candidate for mental health treatment, because of its reliance on symptomological breakdowns of supposed disorders based on nothing more objective than a vote by APA members as to what defines “Authority Defiance Disorder” here, or “General Anxiety Disorder” there. In other words, the psychiatric field is in the business of literally fabricating mental illness to justify putting more people on selective serotonin re-uptake inhibitors (SSRI) and other classes of psychotropics (12); as of June 2013, it is estimated 70 percent of the population are on at least one prescription, more than half are on two, with the second most common type being antidepressants. (13)
In fact, so corrupt is the situation regarding the release of each edition of this reference, even Dr. Allen Frances, once described by the New York Times’ Daniel Goleman as possibly “the most powerful psychiatrist in America at the moment...", resigned from his oversight duties on Volume IV with apologies. “Our panel tried hard to be conservative and careful” he said in a 2010 op-ed for the Los Angeles Times, “but inadvertently contributed to three false ‘epidemics’--attention deficit disorder, autism and childhood bipolar disorder.” (14)
Dr. Leon Eisenberg, quoted by Der Spiegel in Germany as the “scientific father of ADHD”, averred seven months before his death that Attention Deficit Hyperactivity Disorder is a “prime example of a fictitious disease.” (15)
In yet another print media appearance from 2010, Frances glibly summed things up for Wired with: “There is no definition of a mental disorder. It's bullshit. I mean, you just can't define it.” (16)
There are many admissions like these, authoritatively unimpeachable, yet unable to gain any lasting mainstream attention because so much advertising revenue comes from the prescription drugs—especially via television (something that used to be illegal for obvious reasons). To date, only the United States and New Zealand sanction this practice. (17)
Beyond how loosely mental orders are defined there is also an equally imprecise organic basis for what causes them—the catch-all “chemical imbalance” for which mood stabilizers, psycho-stimulants, antidepressants (including SSRIs, which, in particular, have a dramatic effect on the fast-developing judgment centers of the brains of teens and young adults) in the right dosage and combination are supposed to set things right.
There’s only one catch with this catch-all explanation: it’s never been verified.
The Imaginary Imbalance
According to other outspoken critics, like Breggin, Dr. Joanna Moncrieff, Department of Mental Health Services, University College in London and even provisional defenders like Dr. Russell Barkley, Professor of Psychiatry and Neurology at the University of Massachusetts Medical Center, there isn't any credible basis for the idea that brain chemical imbalances are responsible for psychiatric disorders, nor a baseline established for what can be reasonably considered a "normal" balance for any one person. (18)
In fact, you can walk out of a doctor’s office (they don’t even have to be psychiatrists, anymore to prescribe psychoactives) with a prescription or sample of a mood-altering drug without even one specialized blood test, or other form of lab work being performed to measure the presence of a suspected imbalance in the patient’s brain.
To judge by the defensive behavior of Hartford officials following the Newtown shooting, the unwillingness to take a radical view of what happened to Lanza to make him do what he did—namely the effects of medication--suggests the intention of bringing more of the public into the pharmaceutical fold in the future on an institutional basis.
The prevalence and morbid normalization of childhood psychiatric medication, beginning with the use of Ritalin in the early 1970s begs the question of not just what the shooter was taking, but what prescription drugs were the population of his grade-school victims taking, as well? (19)
Besides contributing extensive financial backing to NAMI, Mental Health America and other advocacy groups, the drug industry, as represented by its state policy-shaping membership in the American Legislative Exchange Council (20) (the organization responsible for the NRA-inspired “Stand Your Ground” legislative defense of George Zimmerman in Florida for the shooting of Trevan Martin) (21), has a formidable impact on enshrining psychopharmacology at the centerpiece of treatment plans, with substantive talk therapy and PTSD treatment considered only as adjunctive, or modalities like time-tested nutrition-based orthomolecular medicine as outright quackery. (22)
To be sure, more constructive, healing approaches which incur no lasting iatrogenic side effects, such as mental deficits, tremors, blindness, organ damage and more are occasionally acknowledged, but because insurance will not recognize their efficacy, are unavailable to many caught up in this web spun between the drug companies, compromised medical/social service agencies and the insurance industry. (23)
Due to the debilitating effects of medication, which frequently compound an already challenging psychological condition, the neuro-atypical are unable to work--or, find anything more than part-time work—independent housing and are in no position to afford the hefty out-of-pocket expenses associated with genuinely healing approaches to their condition.
Bedlam’s Return and Legislative Overreach
Following the bombings of the Boston Marathon, now Governor Christie is the latest voice joining opinion-leaders like Steve Forbes in calling for the mainlining of state-mandated psychiatric commitment (24), a practice notorious for its abuses in the nineteenth-century through to the late twentieth, when long-term institutionalization was supplanted by outpatient clinical services.
Last January’s H.R. 274, endorsed by the president and known as The Mental Health First Aid Act of 2013 (a revision of H.R. 5996: Mental Health First Aid Higher Education Act of 2012), would now not only induct administrators and teachers into a training course qualifying them to spot at-risk youth ages 12 through 25, but also include members of the student body, as well. The social consequences of a popular student, or members of an exclusive clique using such authority to target classroom rivals or undesirables could potentially make the cruel backstabbing of an episode of Gossip Girls look like a round of first-grade dodge ball, by comparison. The rollout of this program in Connecticut began with an initial training session held last August attended by one male and 26 female students in the Stamford Government Center. (25)
Local proposals include warranting of state psychiatric evaluation for all Connecticut children who are home-schooled, and, according to Sheila Matthews of AbleChild.org, granting access of the State Department of Children and Family Services to neglected or abused children three years of age and younger for drug/behavioral health research at Yale (Senate Bill 0652), as well as the authority to medicate and even perform surgery on them while in temporary state custody, without informed parental consent (Senate Bill 0833). The latter two passed the Senate in May. (26)
Now if by chance, one were willing to take some comfort that such reforms would be limited to Connecticut, it’s worth noting that Malloy has expressed his hope for the nationwide impact of his Sandy Hook Advisory Commission, charged with submitting its recommendations for state school safety and mental health (with, presumably, plenty of private sector input) by late 2013/early 2014.
Behind the predictable and over-the-top friction between Federal authority and defensive gun advocates, changes below the surface could do far more in the subtle, increased intrusion of psychiatric intervention into the mainstream. One of a series of post-Sandy Hook presidential directives, for instance, permits physicians to inquire if their patients own guns, particularly if they believe there is any cause for concern—given how liability-phobic our health care system has become, it is reasonable to assume doctors would be inclined to err on the side of caution. (27)
In view of the undeniably authoritarian direction Washington has taken in recent years—the disclosures of NSA contractor Edward Snowden only bringing renewed attention to the strangling web of global surveillance post 9/11—drugs as a tool of widespread social control is a real and frightening prospect; the psychiatric incarceration of 9/11 whistleblower Karen Lindauer and, more recently, Facebook dissenter Marine Brandon Raub are precedents that invoke the spectre of the Gulag Archipelago. (28)
Ultimately, though, even removed from such a creepy context, these complicating proposals would probably be as workable as shooting an irritating housefly with an elephant gun—and still missing the target.
Being Serious and Honest—Before Being So Becomes Seriously Abnormal
No, if we are to get realistic about reducing acts of mass violence, we have to be honest enough to look to the causes of such behavior on a societal and cultural scale. Focusing on the dangers of one mode of violence, such as guns (or what types of guns), only diverts attention from confronting the long-denied passive aggressive violence of institutionalized inequality and injustice ever-present in American society and foreign policy, roiling beneath the surface… and getting worse all the time.
It’s not just the medicated/overmedicated who are suffering—be it in response to an inept attempt to address an actual condition, or authority’s contrivance of it; it’s also those still outside the reach of the biopharmacological complex struggling with the circumstances of a society liable to put everyone’s peace of mind at risk, sooner or later.
That man in China mentioned earlier is acknowledged as part of a wave of similar stabbing incidents, attributed to the stress of the many left behind by the country’s tumultuous economic advancement.
Only rarely is social privation as reason for violence acknowledged here with such little reservation, like the particularly shocking 2008 incident at the Tennessee Valley Unitarian Universalist Church in Knoxville where Jim David Adkisson opened fire in the middle of a children’s play to strike against the nearest “liberal” bastion. Unemployed for several years and having just learned his food stamp allotment would be cut back, he as much as admitted he was lashing out on the local level because he felt powerless to be heard by a corrupt political establishment. (29)
These are just some of numerous other factors that also go completely unaddressed in this American debate. Switzerland, for instance, has a comparatively low rate of violent crime, yet gun ownership and responsible proficiency is widespread. But, as cited along with numerous other state and regional examples by Pickett and Wilkinson’s The Spirit Level: Why Greater Equality Makes Societies Stronger (Bloomsbury, 2011), Switzerland also has a more participatory democratic system, has better health care, education, foreign policy, labor/economic, housing outcomes than the US, so obviously, the problem is not simply too many weapons, but too few of those things in life whose absence would drive one to committing violence, or other dysfunctional behavior. (30)
Compare this with the ultimate response in the offing for mental health advancement in the United States: something called the Brain Activity Map Project, a White House $3 billion high-tech proposal for curing autism, schizophrenia and Alzheimer’s Disease (which also has the nasty potential of controlling human minds from a distance). (31)
Unless we demand something better from Washington and our institutions, as with so much of our social policy, this same old mesmerizing, church-around-the-village thinking will continue to exacerbate, rather than remedy our difficulties.
And as mesmerizingly dangerous as they can be, we must not lose sight that guns are still the symptom of a much larger problem: the unjustified disadvantages, exploitation and medicinal quick-fixes with the potential to turn anyone into a weapon.
“Sandy Hook Shooter Adam Lanza Had No Drugs, Alcohol In System”
“Adam Lanza's Body Tested By Medical Examiner For Insight Into Newtown Shooting”
“Parents File Appeal Against Connecticut Medical Examiner’s Refusal to Release Adam Lanza Toxicology Results”, http://www.cchrint.org, 4/5/13
“Parents vs. Gov. Malloy for Lanza Medical Records”
“Full Report Confirms No Drugs, Alcohol In Lanza's System”
“Ablechild’s Appeal For Newtown Shooter’s Medical Records & Toxicology Report Goes to Full CT Fio Commission”
“China: Man with knife slashes 22 school children”
“Linking Zyprexa and TeenScreen Controversies”
“TeenScreen: A Front Group for the Psycho-Pharmaceutical Industrial Complex”
“CCHR: Whistleblower Allen Jones/Mental Health Screening Of Kids”
“Adolescent Mental Health Fact Sheet: Adolescent Mental Health in CONNECTICUT”, www.ct.gov/dss/site/default.asp, 12/15/11
“’TeenScreen’ Directors Resign – Collusion with Pharma cited”
“Leslie McGuire” (via Linkedin)
“NAMI: Nearly 75 Percent of Donations from Pharma”
“making progress in Florida—CONFIDENTIAL”, PDF of Flynn email to Jim McDonough, 3/22/04
“The Lying Liars Who Lie About Psychiatry”
“Psychiatry Goes Insane: Every Human Emotion Now Classified As a Mental Disorder in New Psychiatric Manual DSM-5”
“Study shows 70 percent of Americans take prescription drugs”
“It's not too late to save 'normal'”
“Inventor of ADHD’s Deathbed Confession: ‘ADHD Is a Fictitious Disease’”
"Inside the Battle to Define Mental Illness"
“Should Prescription Drugs Be Advertised Directly to Consumers?”
“Depression Chemical Imbalance Doesn’t Exist, Experts Say”
“The Drugging of Our Children”
“Mental Health America (Formerly National Mental Health Association)”
“The State Legislators Guide to Prescription Drug Policy”
“Seven Faces of NRA/ALEC-Approved ‘Stand Your Ground’ Law”
“Nutritional Approaches And Diets Safely Cure Mental Illness”
“Psychiatric Diagnosis and DSM 5: Maps to Nowhere”
23. Ibid 11.
“Gov. Christie Commits to 'Fully Implementing' Mental Health Treatment Law”
“Steve Forbes: Why The Treatment Of Our Nation's Mentally Ill Is An American Disgrace”
“Testimony by Patricia Rehmer, MSN, Commissioner Department of Mental Health and Addiction Services Before the Mental Health Services Group of the Bipartisan Task Force on Gun Violence Prevention and Children’s Safety”, PDF
“Stamford Teens Take on Mental Health in School”
Sen. Harper, 10th Distr., Rep. Walker, 93rd Dist., State Of Ct, Proposed Bill No. 374: An Act Requiring Behavioral Health Assessments For Children, 1/13
“Legislative Action Alert for May 20th – Connecticut”
“Legislative Action Alert for May 20th—Connecticut”
“Malloy’s Newtown Panel Hoping for National Impact”
“Judge rejects ban on pediatricians asking patients about gun ownership(barf alert)”
“Susan Lindauer--Reporter Held Political Prisoner
to Cover Up U.S. Genocide in Iraq”
“Former Marine Held Involuntarily Over Facebook Posts Now Plans to Sue FBI”
“Affidavit: Man Admits Church Shooting, Says Liberals Should Die”
Halbrook, Stephen P., “Guns, Crime and the Swiss”
“All the President's Neuroscientists”
Rolf Maurer is a member of the Fairfield County Green Party and a former candidate for Stamford Mayor